T3 - PPCP - MTM Flashcards
What is PPCP?
A systematic, consistent process for delivering patient-centered care in any setting
What is assess in the PPCP?
Identify and prioritize problems
What are the components of medication assessment?
Appropriateness
Safety
Effectiveness
Adherence
What is appropriateness?
- Current/ valid indications
- Duplicate therapy
What is safety?
- Adverse effects
- High dose
- Allergic reactions
What is effectiveness?
- Is it working
- Is it achieving the desired therapeutic goals?
What is adherences?
- Cost
- Compliancy
- Other barriers
What is a DRP?
Any undesirable event (or risk of an event) associated with or caused by drug therapy, which interferes with achieving the desired goals of therapy.
What is the most important role of a pharmacist?
To prevent DRP’s from occurring
What are the categories of DRPs associated with appropriateness?
- Unnecessary (duplicate) drug therapy
- Needs additional drug therapy
What are the categories of DRPs associated with safety?
Adverse drug reactions
Dosage to high
What are the categories of DRPs associated with effectiveness?
- Ineffective drugs
- Too low of a dose
What are the categories of DRPs associated with adherence?
Non adherence or non-compliance
What are the common causes of DRPs?
- Unnecessary drug therapy
- Needs additional therapy
- Ineffective drug
- Dosage too low
- ADR
- Dosage too high
- Nonadherence
What are examples of unnecessary drug therapy?
- Duplicate therapy
- No indications
- Non drug therapy more appropriate
What are examples of ineffective drug?
Contraindication
Not indicated for condition
More effective drug available
Dosage form not appropriate
What are examples of needs for additional therapy?
Untreated condition
Preventive treatment
Synergistic therapy
What are examples caused by dosage being too low?
Ineffective dose
Inappropriate frequency, duration, etc.
What are examples caused by ADRs?
Unsafe
Undesirable effect
Drug interaction
Allergic reaction
Inappropriate tapering
What are examples caused by dosages being too high?
Toxicity
Drug interaction
Needs additional monitoring
Inappropriate frequency, duration, etc
What are examples caused by non adherence?
- Cost
- Forgetfulness
- Administration
- Complexity
- Availability
- Lack of understanding
How do you prioritize DRPs?
- Urgency
- Responsibility
- Synergy
What is urgency?
Which problems must be resolved (or prevented) immediately and which can wait?
What is responsibility?
Which problems can be resolved by the practitioner and patient directly?
What is synergy?
Which problems require interventions by someone else (family member, nurse, specialist, etc.)?
What are the components of stating DRPs?
- Description of the patient’s medical condition or clinical state
- Drug therapy involved (causing or solving the problem)
- Specific association between the drug therapy and the patient’s condition
What is medication therapy management (MTM)?
Assessment and evaluation of a patient’s complete medication therapy regimen
What is the purpose for MTM?
- Services that optimize a patient’s therapeutic outcomes
- Improves collaboration and communication
- Usually completed by a pharmacist
- Conducted in various settings either face to face or by phone
What are the core elements of MTM?
- Medication Therapy Review (MTR)
- Personal Medication Record (PMR)
- Medication-Related Action Plan (MAP)
- Intervention and/or Referral
- Documentation and Follow Up
What MTR?
- Uses the steps of the PPCP
- May be comprehensive or targeted to an actual/potential DRP
What is personal medication record?
- Comprehensive record of the patients medication
- Includes medication details
- Includes relevant patient details
What is medication-related action plan?
- Should be patient-centered and collaborative between patient and pharmacist
- Contains a list of actions for the patient to track progress
- Contains only items the patient can act on that are within the pharmacist’s scope of practice
- Should include follow up appointment information, date prepared, provider, pharmacist, and notes for the patient
What is intervention/referral?
- Provide consulting services
- Address DRPs
- Refer when needed
What is documentation?
- Critical for evaluating progress and for billing
- Uses a standard format (ex. SOAP)
- Facilitates communication
- Addresses follow up plans
- Enhances continuity of care
- Demonstrates outcomes and value of pharmacist-provided services
